THE PURPOSE of this paper is twofold: first, to trace the development of obstructive resection for lesions of the colon, and, second, to discuss the use of the Rankin Clamp, which, although originally designed as an instrument for closed anastomosis of the colon, early became identified as an essential aid in undertaking obstructive resection.

Sixty-one years ago, discouraged because of the prohibitive mortality rate that attended resections of the colon (well over 50% in the 58 cases recorded to that date), Block, of Copenhagen, devised an exteriorization procedure which permitted delayed opening of the bowel. However, it was not until 1902 that the maneuver became popular, owing then to the influential advocacy of Mikulicz, by whose name the operation generally became known throughout the country. Although the immediate mortality rate soon was reduced more than half and the popularity of the so-called Mikulicz operation continued for nearly 25 years, a